Oct 31, 2014
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CNA Certification in Massachusetts – An Option For A Successful Medical Field Career

Massachusetts, officially known as the Commonwealth of Massachusetts is located in the New England region of northeastern America. The state is 3rd most densely populated, 7th most extensive and 14 most populous with 6th highest per capita GDP in the United States. MA is also ranked among the 10 best paying state for CNAs.

In addition, the demand of nurse assistants, also known as direct patient care workers or caregivers are very high in the state, because they are specially trained and evaluated in the nursing and basic nursing care procedures through MA nurse aide training and competency evaluation program (NATCEP).

The MA Department of Public Health and the federal Omnibus Reconciliation Acts (OBRA) 1987, 1989 and 1990 approved 75 hours long nurse aide training program (NATP), and American Red Cross offered competency evaluation test (CEP) prepares a caregiver to perform different types of direct health-related tasks on long-term care patients. The successful completion of a state NATP and CEP awards a CNA Certification in Massachusetts, a basic necessity to work in a federal government approved Medicare and Medicaid facilities to perform health care services.

Moreover, CNAs are also awarded a credential of “Certified Nurse Assistant” and listing with the MA Nurse Aide Registry. The credential and listing with the registry also prove that certified nurse assistant is fully competent to work as a frontline care worker in an entry level position.

In accordance to the survey conducted by the PHI Public Works in 2011 on MA direct care workforce, there were 41,620 nursing aides, orderlies and attendants jobs in MA during 2008. It is estimated that by 2018, the demand of nurse assistant jobs will see a rise of 13% or 9,320 additional jobs.

The annual earning and per day wage of a certified nurse assistant, possessing a CNA Certification in Massachusetts is also very lucrative, because the state is known for paying a very high salary to its frontline care workers. The annual salary of a caregiver ranges from $ $21570 to $37800 annually, and per hour wage is $10.369 to $18.18 per hour, according to the USA Bureau of Labor Statistics 2008 report.

There are few factors responsible for CNA salary variations including, greater practical work experience, location, type of facility and additional educational qualification. The salary paid to a nurse aide is also not uniform across the state but varies, depending upon the greater density of population, increased number of ageing population, number of health care facilities and higher cost of living.

Oct 31, 2014
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Even Courts Rely on Mapquest

On January 25, 2007 the United States Court of Appeals for the Seventh Circuit granted a habeas corpus petition relying, in part, upon calculations performed by popular driving direction website Mapquest to determine that the petitioner’s trial counsel had not properly explored petitioner’s alibi before or during his trial on charges of murder and attempted murder. Raygoza v. Hulick, ___ F.3d ___, 2007 WL 184635 (7th Cir. 2007). The Court used Mapquest to determine the distance and travel time between the crime scene and a party petitioner had attended near the time of the crime.

It’s not the first time that Mapquest has been cited as authority in a case. A number of state and federal courts have relied upon Mapquest to determine the distance or travel time between two points. Mapquest has been cited in dozens of reported decisions, including rulings on:

  • motions to change venue in civil cases, where the convenience of the forum to parties and potential witnesses was an issue. Smith v. State Farm Mut. Auto. Ins. Co., 169 Md. App. 286, 292, 900 A.2d 301, 305 (2006); Hoskin v. Un. Pacific Railroad Co., 365 Ill. App.3d 1021, 1025, 851 N.E.2d 646, 650 (2006)
  • motions to transfer a federal criminal case to another district. United States v. Anderson, 2000 WL 34237505, *7 (W.D. Wis. 2000); United States v. Ferguson, 432 F.Supp.2d 559, 563 n. 5 (E.D. Va. 2006)
  • a motion to dismiss, in which the court took judicial notice of the driving distance calculated by Mapquest. Untracht v. Fikri, 454 F.Supp.2d 289, 302 (W.D. Pa. 2006) (citing Gordon v. Lewistown, 272 F.Supp.2d 393, 429 n. 34 (M.D. Pa. 2003))

However, at least one court has held that courts should not take judicial notice of Mapquest results because the website is not sufficiently accurate. Commonwealth v. Brown, 839 A.2d 433, 436-37 (Pa. Super. 2003) (“An internet site determining distances does not have the same inherent accuracy as do professionally accepted medical dictionaries, or encyclopedias, or other matters of common knowledge within the community. The, we hold that the trial court abused its discretion in taking judicial notice of a MapQuest distance determination . . . .”)

Though trial counsel may not be able to count on Mapquest to produce admissible evidence where a timely objection is raised, unchallenged Mapquest results are routinely considered by courts in determining distance or travel time between two points.

Oct 31, 2014
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Sovereign Immunity – Limited Rights to Sue the Government

Sovereign Immunity is the legal defense available to governmental entities which makes it unlawful to sue them. The concept of Sovereign Immunity originated long ago and is associated with the idea that “the King can do no wrong.”

Currently, in Pennsylvania, both state agencies (the Commonwealth, state police, state universities, SEPTA, etc.) and local agencies (townships, boroughs, municipalities, local police and fire departments, etc.) enjoy limited Immunity from civil lawsuits. In addition, when state or local governmental agencies can be sued, the potential recovery is limited, or “capped,” by law.

The following are some of the features of state and local Sovereign Immunity:

Commonwealth parties are generally immune from lawsuits. However, the immunity is not applicable to the following common situations, meaning that an injured person can sue a Commonwealth agency for injuries relating to:

Motor Vehicle Accidents
If a Commonwealth party causes a motor vehicle accident, there is no immunity.

Medical-Professional Liability
There is no immunity for injuries caused by doctors, dentists, nurses or other health care personnel employed by the Commonwealth who cause injury.

Commonwealth Real Estate, Highways and Sidewalks
Under certain circumstances, the Commonwealth remains legally responsible for failing to correct or properly maintain its real estate.

Potholes and Sinkholes
The Commonwealth can be held liable for personal injuries (but not property damage) caused by potholes or sinkholes, but only if the injured party can prove that the Commonwealth had actual written notice of the condition a sufficient time prior to the accident to have corrected the condition.

Liquor Store Sales
The Commonwealth remains liable for injuries caused by serving minors, visibly intoxicated persons or others who it is illegal to serve under the Liquor Code.

Animals Under Control of Commonwealth
The Commonwealth remains liable for injuries caused by its animals, like police dogs or horses.

In legal actions against the Commonwealth, there is a limit, or “cap” on the amount of the recovery of $250,000 for any person and $1,000,000 for any single accident.

Like the Commonwealth, local agencies enjoy immunity, but it is waived for the following types of cases:

Vehicle Liability
If a local agency party causes a motor vehicle accident, there is no immunity.

Real Property
Under certain circumstances, the local agency remains legally responsible for failing to correct or properly maintain its real estate.

Trees, Traffic Controls, Street Lighting, Sidewalks, Utility Service Facilities, and Streets
The agency can be held liable for personal injuries, but only if it can be shown that it had actual notice of the condition or could reasonably be expected to know of the condition and had enough time prior to the accident to fix it.

The agency remains liable for injuries caused by its animals.

Damages recoverable against a local agency are capped at $500,000 per accident. In addition, injured parties may not make claims for pain and suffering, unless the injury results in death, a permanent loss of a body function, permanent disfigurement or permanent dismemberment.

Oct 31, 2014
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Disputing a Medical Bill Debt on a Credit Report

Medical bill debt is a plague that affects millions of Americans. A recent Commonwealth Fund study shows that 41% of American adults had trouble managing their medical bill debts. Problems pile up as such debts have a major impact on credit scores or ratings. In these dire economic times, creditors are becoming stricter about credit scores – to receive credit cards or loans; you must have a score that is above 740. However, take heart. There are proactive answers available to remedy your woes.

One way is to confront debts before it reaches collections. It may be very unfair for you to pay your hospital bills, which is actually the responsibility of your insurance company. However, you are in for a big problem if you do not pay the bill, in the end the amount you end up paying could be higher than what it was supposed to be.

Keep your unpaid bill from reaching collections by talking to the hospital’s billing department, saying you are waiting for your insurance company, and putting medical bills into dispute. This will keep your unpaid bill in limbo while you and the insurance company slug it off. Do not take it for granted that your insurance company will pay the bills. You must also avoid making arrangements with the billing office as their system will fast track it over to a collections agency, and eventually to your credit company.

Once your unpaid medical bill goes to a collection agency, you will have a much harder time rectifying it. In such case, you will need to contact the credit agency directly and set off a dispute. You can dispute a medical bill debt over the phone, online, or in writing. You will need to show evidence that your insurance company was responsible for paying off your medical bill. If the company refuses to pay stating that your health plan does not cover it, try to resolve this issue at your doctor’s office.

In both cases, you will need to document every communication you had with the insurance company and the hospital to send to a credit reporting agency. Include detailed information such as dates, times, a copy of pertinent sections in your insurance manual, and people you spoke with at the insurance company as well as your doctor’s office. Show them anything that will support your case.

You can file a dispute online at each of the following major credit agency’s website: TransUnion Consumer Solutions Experian, and Equifax Information Services, LLC. The Fair Credit Reporting Act requires the credit agency to investigate within 30 days upon your request.

Oct 31, 2014
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Union Finance Budget for Financial Year 2007-2008, Government of India… (India is Shining)

Union Finance Minister (Govt. of India) P Chidambaram presented the Union Budget for 2007-08 in Parliament on Wednesday, 28th Feb. 2007.

The Following are the Highlights:

While Chidambaram kept income tax limit unchanged, he increased the threshold limit by Rs 10,000 giving every assessee a relief of Rs 1,000.

Deduction in respect of medical insurance under Section 80 (D) increased to Rs 15,000 and Rs 20,000 for senior citizens.

Exemption limit for women was increased to Rs 145,000 and for senior citizens to Rs 195,000.

Dividend distribution tax raised from 12.5 to 15 per cent.

ESOPs to be brought under FBT.

Expenditure on samples and free distribution items to be exempted from fringe benefit tax.

Additional revenue from direct taxes to yield Rs 3000 crore and indirect taxes revenue neutral.

Tax exemption on aviation turbine fuel sold to turbo prop aircraft extended to all small aircraft less than 40,000 kg.

Withdrawals by central and state governments exempted from Banking Cash Transaction Tax. The limit for individuals and HUF raised from Rs 25,000 to Rs 50,000.

Two lakh people to benefit out of service tax exemption. Govt to lose Rs 800 crore as a result.

Service tax on Residents Welfare Associations whose members contribute more than Rs 3,000.

Surcharge on Corporate income tax on companies below Rs one crore removed.

Tax free bonds to be issued by state-owned urban local bodies.

Five year tax holiday for two, three, four star hotels and convention centres with a seating capacity of 3,000 in NCT of Delhi, Gurgaon, Ghaziabad, Faridabad and Gautam

Minimum Alternate Tax being extended.

Benefits of investment in venture capital funds confined to IT, bio-technology, nano-technology, seed research, dairy among some others.

Excise duty on cement reduced from Rs.400 per tonne to Rs.350 per tonne for cement bags sold at Rs.190 per bag at retail market. Those sold above Rs.190 will attract excise duty of Rs.600 per tonne.

Corporate tax: No surcharge for firms with a taxable income of Rs 1 crore (Rs 10 million) or less.

E-governance allocation to be increased from Rs.395 to Rs.719 crore.

Indian investors to be allowed investment in overseas capital markets through mutual funds. Mutual funds to set up Infrastructure Fund schemes.

Any requirement for security of the nation to be provided.

Backward Regions Grant Fund to be raised to Rs 5800 crore.

A high-powered committee report aimed at making Mumbai a world class financial centre submitted.

Public suggestions will be invited.

Rs 50 crore provided to begin work on vocational education mission for which Task Force in Planning Commission is chalking out a strategy.

1,396 Indian Technical Institutes to be upgraded to achieve technical excellence.

An autonomous Debt Management Office in government to be set up.

Government to create one lakh jobs for physically challenged. Government will reimburse the EPF contributions of employers in the case of physically challenged people taken on rolls of the company and included in the PF scheme. A fund of Rs 150 crore to be started which will go up to Rs 450 crore.

An Expert Committee to be set up to study the impact of climate change in India.

Rs 150 crore to be given to Ministry of Youth and Sports for Commonwealth Games and Rs 350 crore to the Delhi Government for the purpose. Rs 50 crore to be provided for the Commonwealth Youth Games in Pune.

Rs 100 crore for recognising excellence in the field of agricultural research.

VAT revenues increased by 24.3 per cent in the first nine months of 2006-07.

A national level goods and services tax to be introduced from next fiscal.

Fiscal deficit to be 3.7 per cent in the current year and revenue deficit two per cent.

Fiscal management enabled States consolidate debt to the tune of Rs.1,10,268 crore and 20 states availed of debt waiver to the tune of Rs.8575 crores. The share of States from the revenue expected to touch Rs.1,42,450 crore during 2007-08 as against Rs.1,20,377 crore during 2006-07.

Total expenditure estimated at Rs 6,81,521 crore.

Increase in gross tax revenue by 19.9 per cent, 20 per cent and 27.8 per cent in first three years of UPA government. Intend to keep tax rates moderate.

Peak customs duty rate on non-agricultural items reduced from 12.5 to ten per cent.

All coking coal fully exempted from duty.

Duties on seconds and defective reduced from 20 to ten per cent.

Customs duty on polyster to be reduced from ten per cent to 7.5 per cent.

Fiscal deficit for 2007-08 pegged at 3.3 per cent of GDP at Rs.1,50,948 crore. Revenue deficit at Rs.72,478 crore which will be 1.5 per cent.

Total expenditure during 2006-07 estimated at Rs.6,80,521 crore including Rs.40,000 crore for SBI shares.

Duty on pet food reduced from 30 per cent to 20 per cent.

Duty on sunflower oil to be reduced by 15 per cent.

Duty reduced on watch dials and movements and umbrella parts from 12.5 to five per cent.

Import duty of 15 specified machinery to be reduced from 7.5 per cent to five per cent.

Economy grows 8.6 per cent in third quarter of this fiscal compared to 9.3 per cent in the year-ago period

Three per cent import duty to be levied on private importers of aircraft including helicopters.

No change in general CENVAT rate.

Ad valorem duty on petrol and diesel to be brought down from eight to six per cent.

Export duty on iron ore and concentrate at the rate of Rs.300 per tonne. Export duty on Cromium proposed at Rs 2000 tonne.

Small-scale industries excise duty exemption raised from Rs one crore to Rs 1.5 crore.

Manufacturing sector grows at 10.7 per cent, agriculture at 1.5 per cent during October-December 2006-07.

Excise duty for plywood reduced from 16 per cent to eight per cent.

Food mixes to be fully exempted from excise duty.

Excise duty for plywood reduced from 16 per cent to eight per cent.

Bio-diesel to be fully exempted from excise duty.

Water purification devices, small and big, fully exempted from excise. Specific rates of excise duty on cigarettes increased.

Excise duty on Pan Masala without tobacco as mouth freshners reduced from 66 per cent to 45 per cent.

PAN to be made single identity card for all securities/stocks/MFs related transactions.

Insurance companies to launch a senior citizens scheme in 2007-08.

Defence budget increased to Rs 96,000 crore

Tourism infrastructure to get an allocation of Rs.520 crore as against Rs.423 crore last year.

The ceiling of loans for weaker sections under deferential rate of interest scheme will be raised from Rs 6500 to Rs 15,000 and in housing loan from Rs 5000 to Rs 20,000.

Regulations would be put in place for mortgage guarantee company for housing loans.

Regional Rural Banks, which are willing to take up greater responsibilities, to undertake aggressive branch expansion programme. One RRB branch for each of 80 districts so far uncovered. RRBs to accept NRE and FCNR deposits.

FDI inflows between April and January this fiscal touched $12.5 bn while portfolio investment reached $6.8 billion

Technology Upgration Fund in textiles to continue during the 11th Plan. Rs 911 crore to be provided for this.

Allocation for National Highway Development programme to be stepped up from Rs 9,955 crore to Rs 12,600 crore.

Work on Golden Quadrilateral road project nearly complete. Considerable progress made on North-South, East-West corridor and likely to be completed by 2009.

Northeastern region will get Rs 405 crore for highway development. Road-cum-rail project over Brahmaputra in Bogibil, Assam.

Health insurance cover for weavers to be enlarged to ancillary industries. Allocation increased from Rs 241 crore to Rs 321 crore.

A scheme for modernisation and technological upgradation of choir industry for which Rs 23.55 crore has been earmarked.

Manufacturing growth rate estimated at 11.3 per cent.

9.2 per cent GDP growth rate estimated in 2006-07.

Average growth for last three years is 8.6 per cent.

Saving rate of 32.4 per cent, investment rate of 33.8 per cent will continue.

A number of proposals to perk up agriculture to be announced.

Average inflation in FY’07 to be 5.2-5.4 per cent; govt confident of managing inflation

Bank credit rate grew by 29 per cent during first ten months of 2006-07

Inflation during 2006-07 estimated at between 5.2 and 5.4 per cent against 4.4 per cent during the previous year.

Abhijit Sen report on forward trading to be submitted in two months’ time.

Additional irrigation potential of 24 lakh hectares to be implemented, including nine lakh hectares under Accelerated Irrigation Benefit Programme.

Economy in a stronger position than ever before.

15,054 villages have been covered under rural telephony and efforts to be made to complete the target of covering 20,000 villages by 2006-07.

Allocation on Healthcare to increase by 21.9 per cent.

Allocattion for education to be enhanced by 34.2 per cent.

Two lakh more teachers to be employed and five lakh more classrooms to be constructed.

Secondary education allowance to be increased from Rs.1,837 crore to Rs.3,794 crore.

Government committed to fiscal reforms.

Foreign exchange reserves stand at 180 billion dollars.

Allocation under Rajiv Gandhi Drinking Mission stepped up from Rs 4680 crore to Rs 5850 crore.

Government concerned over inflation and would take all steps for moderating it.

Already a number of steps on fiscal, monetary and supply management side have been taken.

Annual target of 15 lakh houses under Bharat Nirmal Programme to be exceeded.

Allocation for National Rural Health Mission stepped up from Rs 8207 crore to Rs 9947 crore.

Gross budgetary support in 2007-08 raised to Rs 2,05,100 crore from 1,72,728 crore in 2006-07. Of this, budgetary support to the Central plan will go up to 1,54,939 crore against 1,72,728 crore.

School dropout rates high. To prevent dropout, a National Means-cum-Merit scholarship to be implemented, with an allocation of Rs 6,000 per child.

Rs 1290 crore to be provided for elimination of polio. Intensive coverage will be undertaken in 20 districts in UP and 10 districts in Bihar. This will be integrated into NRHM.

National AIDS Control Programme to achieve zero level disease.

Measures for significant improvement of health care in rural area.

Allocation for ICDS programme to be increased from Rs 4087 crore to Rs 4761 crore.

30 more districts under NREGA. Additional allocation of Rs.12,000 crore for it.

Rs 800 crore for Sampoorna Gram Rozgar Yojana in districts not covered by NREGA. Swarna Jayanti Swarozgar Yojana allocation increased from Rs 250 crore to Rs 344 crore.

Computerisation of PDS and integrated computerization programme for FCI.

Allocation for schemes only for SCs and STs to be increased to Rs 3271 crore.

Rs 63 crore for share capital for National Minorities Development Finance Corporation following Sachar Committee recommendations.

Allocation for SC/ST scholarships enhanced from Rs.440 crore to Rs.611 crore.

Scholarships programme for minorities students to be of the order of Rs 72 crore for pre-metric, Rs 48 crore for graduate and postgraduate.

Total Budget for the Northeastern region raised from Rs 12,041 crore to Rs 14,365 crore.

New Industrial Policy for the northeastern region to be in place before March 31.

Women’s development allocation will be Rs.22,282 crore.

Rs 7,000 crore allocation for better tax administration to be used for social schemes.

Rs 2,25,000 crore farm credit proposed in the new budget. A target of additional 50 lakh farmers to be brought under farm credit.

Farmers’ credit likely to reach Rs.1,90,000 crore as against the targeted Rs.1,75,000 crore during 2006-07.

Special Purpose Tea Fund to rejuvenate tea production.

Rs 100 crore allocated for National Rainfed Area Authority.

One hundred per cent subsidy for small farmers and 50 per cent for other farmers for water recharging scheme.

World Bank signed agreement for revival of 5,763 waterbodies in Tamil Nadu. Loan component Rs 2,182 crore. To have a command area of four lakh hectares. Similar agreement with Andhra Pradesh in March for recharge of 2,000 bodies. Command area 2.5 lakh hectares.

Bonds worth Rs 5,000 crore to augment NABARD to be issued.

Death and disability cover for rural landless families to be introduced, known as ‘Aam Aadmi Bima Yojana’.

70 lakh households to be covered under a social welfare scheme with LIC and with support from state governments.

50 per cent of the premium at Rs.200 per household to be given by the Centre. Rs.1,000 crore fund to be maintained by LIC for the purpose.

Central public sector enterprises will be given Rs 16,261 crore as equity support and loans of over Rs 2600 crore.

Sources: Times of India; NDTV; StarNews